| NPI | 1043648736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 0S13013) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL os13013) |
| 207P00000X Emergency Medicine (Licence: FL UO2923) | |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2020-10-14 |